401k Plan data: APPLIED ENGINEERING MGMT CORP LIFE INSURANCE BENEFIT PLAN plan

APPLIED ENGINEERING MGMT CORP LIFE INSURANCE BENEFIT PLAN 401k Plan overview

Plan Name	APPLIED ENGINEERING MGMT CORP LIFE INSURANCE BENEFIT PLAN
Plan identification number	502

APPLIED ENGINEERING MGMT CORP LIFE INSURANCE BENEFIT PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Life insurance Dental Long-term disability cover Death benefits (include travel accident but not life insurance)

401k Sponsoring company profile

APPLIED ENGINEERING MANAGEMENT CORPORATION has sponsored the creation of one or more 401k plans.

Company Name: APPLIED ENGINEERING MANAGEMENT CORPORATION

Employer identification number (EIN): 770113181

NAIC Classification: 541511
NAIC Description: Custom Computer Programming Services

Additional information about APPLIED ENGINEERING MANAGEMENT CORPORATION

Jurisdiction of Incorporation: Texas Secretary of State

Incorporation Date: 1996-03-03

Company Identification Number: 0011094006

Legal Registered Office Address: PO BOX 1263

CAMARILLO
United States of America (USA)
93011

More information about APPLIED ENGINEERING MANAGEMENT CORPORATION

Form 5500 Filing Information

Submission information for form 5500 for 401k plan APPLIED ENGINEERING MGMT CORP LIFE INSURANCE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
502 2017-01-01 SHARON DEMONSABERT
502 2017-01-01
502 2016-01-01 SHARON DEMONSABERT
502 2015-01-01 SHARON DEMONSABERT
502 2014-01-01 SHARON DEMONSABERT
502 2013-01-01 SHARON DEMONSABERT
502 2012-01-01 SHARON DEMONSABERT
502 2011-01-01 SHARON DEMONSABERT
502 2010-01-01 SHARON DEMONSABERT
502 2009-01-01 SHARON DEMONSABERT

Plan Statistics for APPLIED ENGINEERING MGMT CORP LIFE INSURANCE BENEFIT PLAN

401k plan membership statisitcs for APPLIED ENGINEERING MGMT CORP LIFE INSURANCE BENEFIT PLAN

Measure Date Value
2017: APPLIED ENGINEERING MGMT CORP LIFE INSURANCE BENEFIT PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 231
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 243
Total of all active and inactive participants 2017-01-01 243
Total participants 2017-01-01 243
Number of retired or separated participants receiving benefits 2017-01-01 0
Number of other retired or separated participants entitled to future benefits 2017-01-01 0
2016: APPLIED ENGINEERING MGMT CORP LIFE INSURANCE BENEFIT PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 196
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 231
Total of all active and inactive participants 2016-01-01 231
Total participants 2016-01-01 231
2015: APPLIED ENGINEERING MGMT CORP LIFE INSURANCE BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 163
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 196
Total of all active and inactive participants 2015-01-01 196
Total participants 2015-01-01 0
2014: APPLIED ENGINEERING MGMT CORP LIFE INSURANCE BENEFIT PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 131
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 163
Total of all active and inactive participants 2014-01-01 163
Total participants 2014-01-01 0
2013: APPLIED ENGINEERING MGMT CORP LIFE INSURANCE BENEFIT PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 121
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 131
Total of all active and inactive participants 2013-01-01 131
Total participants 2013-01-01 0
2012: APPLIED ENGINEERING MGMT CORP LIFE INSURANCE BENEFIT PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 112
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 121
Total of all active and inactive participants 2012-01-01 121
Total participants 2012-01-01 0
2011: APPLIED ENGINEERING MGMT CORP LIFE INSURANCE BENEFIT PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 88
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 112
Total of all active and inactive participants 2011-01-01 112
Total participants 2011-01-01 112
2010: APPLIED ENGINEERING MGMT CORP LIFE INSURANCE BENEFIT PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 89
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 92
Total of all active and inactive participants 2010-01-01 92
Total participants 2010-01-01 92
2009: APPLIED ENGINEERING MGMT CORP LIFE INSURANCE BENEFIT PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 107
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 89
Total of all active and inactive participants 2009-01-01 89
Total participants 2009-01-01 89

Measure	Date	Value
2017: APPLIED ENGINEERING MGMT CORP LIFE INSURANCE BENEFIT PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	231
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	243
Total of all active and inactive participants	2017-01-01	243
Total participants	2017-01-01	243
Number of retired or separated participants receiving benefits	2017-01-01	0
Number of other retired or separated participants entitled to future benefits	2017-01-01	0
2016: APPLIED ENGINEERING MGMT CORP LIFE INSURANCE BENEFIT PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	196
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	231
Total of all active and inactive participants	2016-01-01	231
Total participants	2016-01-01	231
2015: APPLIED ENGINEERING MGMT CORP LIFE INSURANCE BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	163
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	196
Total of all active and inactive participants	2015-01-01	196
Total participants	2015-01-01	0
2014: APPLIED ENGINEERING MGMT CORP LIFE INSURANCE BENEFIT PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	131
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	163
Total of all active and inactive participants	2014-01-01	163
Total participants	2014-01-01	0
2013: APPLIED ENGINEERING MGMT CORP LIFE INSURANCE BENEFIT PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	121
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	131
Total of all active and inactive participants	2013-01-01	131
Total participants	2013-01-01	0
2012: APPLIED ENGINEERING MGMT CORP LIFE INSURANCE BENEFIT PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	112
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	121
Total of all active and inactive participants	2012-01-01	121
Total participants	2012-01-01	0
2011: APPLIED ENGINEERING MGMT CORP LIFE INSURANCE BENEFIT PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	88
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	112
Total of all active and inactive participants	2011-01-01	112
Total participants	2011-01-01	112
2010: APPLIED ENGINEERING MGMT CORP LIFE INSURANCE BENEFIT PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	89
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	92
Total of all active and inactive participants	2010-01-01	92
Total participants	2010-01-01	92
2009: APPLIED ENGINEERING MGMT CORP LIFE INSURANCE BENEFIT PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	107
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	89
Total of all active and inactive participants	2009-01-01	89
Total participants	2009-01-01	89

Financial Data on APPLIED ENGINEERING MGMT CORP LIFE INSURANCE BENEFIT PLAN

Measure	Date	Value
2017 : APPLIED ENGINEERING MGMT CORP LIFE INSURANCE BENEFIT PLAN 2017 401k financial data
Value of total assets at end of year	2017-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2017-12-31	No
Was this plan covered by a fidelity bond	2017-12-31	No
If this is an individual account plan, was there a blackout period	2017-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2017-12-31	No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-12-31	No
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2017-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2017-12-31	No
Were any leases to which the plan was party in default or uncollectible	2017-12-31	No
Value of interest in common/collective trusts at end of year	2017-12-31	$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2017-12-31	No
Was there a failure to transmit to the plan any participant contributions	2017-12-31	No
Has the plan failed to provide any benefit when due under the plan	2017-12-31	No
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2017-12-31	No
Did the plan have assets held for investment	2017-12-31	No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2017-12-31	No

Form 5500 Responses for APPLIED ENGINEERING MGMT CORP LIFE INSURANCE BENEFIT PLAN

2017: APPLIED ENGINEERING MGMT CORP LIFE INSURANCE BENEFIT PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Submission has been amended	Yes
2017-01-01	This submission is the final filing	Yes
2017-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2017-01-01	Plan is a collectively bargained plan	No
2017-01-01	Plan funding arrangement – Insurance	Yes
2017-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2017-01-01	Plan benefit arrangement – Insurance	Yes
2017-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2016: APPLIED ENGINEERING MGMT CORP LIFE INSURANCE BENEFIT PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2015: APPLIED ENGINEERING MGMT CORP LIFE INSURANCE BENEFIT PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Plan funding arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2014: APPLIED ENGINEERING MGMT CORP LIFE INSURANCE BENEFIT PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Plan funding arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2013: APPLIED ENGINEERING MGMT CORP LIFE INSURANCE BENEFIT PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2012: APPLIED ENGINEERING MGMT CORP LIFE INSURANCE BENEFIT PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2011: APPLIED ENGINEERING MGMT CORP LIFE INSURANCE BENEFIT PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Plan funding arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2010: APPLIED ENGINEERING MGMT CORP LIFE INSURANCE BENEFIT PLAN 2010 form 5500 responses
2010-01-01	Type of plan entity	Single employer plan
2010-01-01	Plan funding arrangement – Insurance	Yes
2010-01-01	Plan benefit arrangement – Insurance	Yes
2009: APPLIED ENGINEERING MGMT CORP LIFE INSURANCE BENEFIT PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Plan funding arrangement – Insurance	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

000010103279

Policy instance

Insurance contract or identification number	000010103279
Number of Individuals Covered	243
Insurance policy start date	2016-07-01
Insurance policy end date	2017-06-30
Total amount of commissions paid to insurance broker	USD $1,114
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	Yes
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	AD&D, LIFE
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Welfare Benefit Premiums Paid to Carrier	USD $18,183
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

SGD608566

Policy instance

Insurance contract or identification number	SGD608566
Number of Individuals Covered	235
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $4,399
Total amount of fees paid to insurance company	USD $1,313
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	Yes
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Welfare Benefit Premiums Paid to Carrier	USD $43,992
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

SGM608081

Policy instance

Insurance contract or identification number	SGM608081
Number of Individuals Covered	325
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $4,582
Total amount of fees paid to insurance company	USD $1,408
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Welfare Benefit Premiums Paid to Carrier	USD $45,822
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

VDT601974

Policy instance

Insurance contract or identification number	VDT601974
Number of Individuals Covered	33
Insurance policy start date	2017-04-01
Insurance policy end date	2018-04-01
Total amount of commissions paid to insurance broker	USD $1,420
Other welfare benefits provided	SHORT TERM DISABILITY
Welfare Benefit Premiums Paid to Carrier	USD $14,199
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,420
Insurance broker name	TOLMAN & WIKER INSURANCE

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

SGD608566

Policy instance

Insurance contract or identification number	SGD608566
Number of Individuals Covered	235
Insurance policy start date	2017-01-01
Insurance policy end date	2018-01-01
Total amount of commissions paid to insurance broker	USD $4,399
Total amount of fees paid to insurance company	USD $1,313
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $43,992
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $4,399
Amount paid for insurance broker fees	1313
Additional information about fees paid to insurance broker	OVERRIDE
Insurance broker organization code?	3
Insurance broker name	TOLMAN & WIKER INSURANCE

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

SDK605908

Policy instance

Insurance contract or identification number	SDK605908
Number of Individuals Covered	235
Insurance policy start date	2017-01-01
Insurance policy end date	2018-01-01
Total amount of commissions paid to insurance broker	USD $832
Total amount of fees paid to insurance company	USD $244
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	ACCIDENTAL DEATH
Welfare Benefit Premiums Paid to Carrier	USD $8,319
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $832
Amount paid for insurance broker fees	244
Additional information about fees paid to insurance broker	OVERRIDE
Insurance broker organization code?	3
Insurance broker name	TOLMAN & WIKER INSURANCE SERVICES

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

SGM608081

Policy instance

Insurance contract or identification number	SGM608081
Number of Individuals Covered	325
Insurance policy start date	2017-01-01
Insurance policy end date	2018-01-01
Total amount of commissions paid to insurance broker	USD $4,582
Total amount of fees paid to insurance company	USD $1,408
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $45,822
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $4,582
Amount paid for insurance broker fees	1408
Additional information about fees paid to insurance broker	OVERRIDE
Insurance broker organization code?	3
Insurance broker name	TOLMAN & WIKER INSURANCE

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

000010103279

Policy instance

Insurance contract or identification number	000010103279
Number of Individuals Covered	243
Insurance policy start date	2016-07-01
Insurance policy end date	2017-06-30
Total amount of commissions paid to insurance broker	USD $1,114
Life Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Other welfare benefits provided	AD&D, LIFE
Welfare Benefit Premiums Paid to Carrier	USD $18,183
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,114
Insurance broker organization code?	3
Insurance broker name	TOLMAN & WIKER INS SVCS LLC

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

000010104302

Policy instance

Insurance contract or identification number	000010104302
Number of Individuals Covered	230
Insurance policy start date	2016-07-01
Insurance policy end date	2017-06-30
Total amount of commissions paid to insurance broker	USD $2,704
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $22,646
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,704
Insurance broker organization code?	3
Insurance broker name	TOLMAN & WIKER INS SVCS LLC

CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )

Policy contract number

00613557

Policy instance

Insurance contract or identification number	00613557
Number of Individuals Covered	368
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $149,148
Total amount of fees paid to insurance company	USD $183,708
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $929,843
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $74,574
Amount paid for insurance broker fees	181287
Additional information about fees paid to insurance broker	CONTRACT ADMINISTRATION
Insurance broker organization code?	5
Insurance broker name	TOLMAN & WIKER INSURANCE SERVICES

CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )

Policy contract number

0613557

Policy instance

Insurance contract or identification number	0613557
Number of Individuals Covered	135
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $10,314
Total amount of fees paid to insurance company	USD $606
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $104,285
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $10,314
Amount paid for insurance broker fees	606
Additional information about fees paid to insurance broker	SERVICE/GENERAL AGENT PAYMENTS
Insurance broker organization code?	3
Insurance broker name	TOLMAN & WIKER INSURANCE SERVICES

CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )

Policy contract number

0613557

Policy instance

Insurance contract or identification number	0613557
Number of Individuals Covered	135
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $10,314
Total amount of fees paid to insurance company	USD $606
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Welfare Benefit Premiums Paid to Carrier	USD $104,285
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

SDK605908

Policy instance

Insurance contract or identification number	SDK605908
Number of Individuals Covered	235
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $832
Total amount of fees paid to insurance company	USD $244
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	ACCIDENTAL DEATH
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Welfare Benefit Premiums Paid to Carrier	USD $8,319
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

000010104302

Policy instance

Insurance contract or identification number	000010104302
Number of Individuals Covered	230
Insurance policy start date	2016-07-01
Insurance policy end date	2017-06-30
Total amount of commissions paid to insurance broker	USD $2,704
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	Yes
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Welfare Benefit Premiums Paid to Carrier	USD $22,646
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

ANTHEM BLUE CROSS AND BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 71835 )

Policy contract number

83612

Policy instance

Insurance contract or identification number	83612
Number of Individuals Covered	188
Insurance policy start date	2014-07-01
Insurance policy end date	2015-06-30
Total amount of commissions paid to insurance broker	USD $41,760
Health Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $2,503,111
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $38,660
Insurance broker organization code?	3
Insurance broker name	NIELSEN INSURANCE GROUP

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

000010103279

Policy instance

Insurance contract or identification number	000010103279
Number of Individuals Covered	197
Insurance policy start date	2014-07-01
Insurance policy end date	2015-06-30
Total amount of commissions paid to insurance broker	USD $1,304
Total amount of fees paid to insurance company	USD $355
Life Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Other welfare benefits provided	AD&D, LIFE
Welfare Benefit Premiums Paid to Carrier	USD $24,220
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,304
Insurance broker organization code?	3
Amount paid for insurance broker fees	355
Additional information about fees paid to insurance broker	BROKER BONUS
Insurance broker name	DIGITAL INSURANCE INC

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

000010104302

Policy instance

Insurance contract or identification number	000010104302
Number of Individuals Covered	196
Insurance policy start date	2014-07-01
Insurance policy end date	2015-06-30
Total amount of commissions paid to insurance broker	USD $4,504
Total amount of fees paid to insurance company	USD $756
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $50,349
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $4,504
Insurance broker organization code?	3
Amount paid for insurance broker fees	756
Additional information about fees paid to insurance broker	BROKER BONUS
Insurance broker name	DIGITAL INSURANCE INC

CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )

Policy contract number

00613557

Policy instance

Insurance contract or identification number	00613557
Number of Individuals Covered	203
Insurance policy start date	2015-07-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $31,563
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $335,743
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $31,563
Insurance broker name	TOLMAN & WIKER INSURANCE SERVICES

ANTHEM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61069 )

Policy contract number

21721000V

Policy instance

Insurance contract or identification number	21721000V
Number of Individuals Covered	163
Insurance policy start date	2013-07-01
Insurance policy end date	2014-06-30
Total amount of commissions paid to insurance broker	USD $828
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $5,229
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $828
Insurance broker organization code?	3
Insurance broker name	CRAIG L NIELSEN

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

000010103279

Policy instance

Insurance contract or identification number	000010103279
Number of Individuals Covered	163
Insurance policy start date	2013-07-01
Insurance policy end date	2014-06-30
Total amount of commissions paid to insurance broker	USD $1,156
Total amount of fees paid to insurance company	USD $136
Life Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Other welfare benefits provided	AD&D, LIFE
Welfare Benefit Premiums Paid to Carrier	USD $19,398
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,156
Insurance broker organization code?	3
Amount paid for insurance broker fees	136
Additional information about fees paid to insurance broker	BROKER BONUS
Insurance broker name	DIGITAL INSURANCE AGENCY

ANTHEM BLUE CROSS AND BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 71835 )

Policy contract number

21721

Policy instance

Insurance contract or identification number	21721
Number of Individuals Covered	155
Insurance policy start date	2013-07-01
Insurance policy end date	2014-06-30
Total amount of commissions paid to insurance broker	USD $33,500
Health Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $1,635,869
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $33,500
Insurance broker organization code?	3
Insurance broker name	NIELSEN INSURANCE GROUP

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

000010104302

Policy instance

Insurance contract or identification number	000010104302
Number of Individuals Covered	163
Insurance policy start date	2013-07-01
Insurance policy end date	2014-06-30
Total amount of commissions paid to insurance broker	USD $4,070
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $41,403
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $4,070
Insurance broker organization code?	3
Insurance broker name	DIGITAL INSURANCE INC

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

000010104302

Policy instance

Insurance contract or identification number	000010104302
Number of Individuals Covered	131
Insurance policy start date	2012-07-01
Insurance policy end date	2013-06-30
Total amount of commissions paid to insurance broker	USD $3,762
Total amount of fees paid to insurance company	USD $571
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $35,229
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $3,061
Amount paid for insurance broker fees	571
Additional information about fees paid to insurance broker	BROKER BONUS
Insurance broker organization code?	3
Insurance broker name	DIGITAL INSURANCE INC

ANTHEM BLUE CROSS AND BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 71835 )

Policy contract number

21721

Policy instance

Insurance contract or identification number	21721
Number of Individuals Covered	128
Insurance policy start date	2012-07-01
Insurance policy end date	2013-06-30
Total amount of commissions paid to insurance broker	USD $27,381
Health Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $1,464,645
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $27,300
Insurance broker organization code?	3
Insurance broker name	CRAIG L NIELSEN

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

000010103279

Policy instance

Insurance contract or identification number	000010103279
Number of Individuals Covered	131
Insurance policy start date	2012-07-01
Insurance policy end date	2013-06-30
Total amount of commissions paid to insurance broker	USD $1,024
Total amount of fees paid to insurance company	USD $225
Life Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Other welfare benefits provided	AD&D, LIFE
Welfare Benefit Premiums Paid to Carrier	USD $15,618
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $464
Amount paid for insurance broker fees	225
Additional information about fees paid to insurance broker	BROKER BONUS
Insurance broker organization code?	3
Insurance broker name	DIGITAL INSURANCE INC

ANTHEM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61069 )

Policy contract number

21721000V

Policy instance

Insurance contract or identification number	21721000V
Insurance policy start date	2012-07-01
Insurance policy end date	2013-06-30
Total amount of commissions paid to insurance broker	USD $665
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $4,579
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $665
Insurance broker organization code?	3
Insurance broker name	NIELSEN INSURANCE COMPANY

ANTHEM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61069 )

Policy contract number

21721000V

Policy instance

Insurance contract or identification number	21721000V
Insurance policy start date	2011-07-01
Insurance policy end date	2012-06-30
Total amount of commissions paid to insurance broker	USD $499
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $3,984
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $499
Insurance broker organization code?	3
Insurance broker name	NIELSEN INSURANCE COMPANY

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

000010104302

Policy instance

Insurance contract or identification number	000010104302
Insurance policy start date	2011-07-01
Insurance policy end date	2012-06-30
Total amount of commissions paid to insurance broker	USD $3,570
Total amount of fees paid to insurance company	USD $553
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $31,391
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $3,570
Amount paid for insurance broker fees	553
Additional information about fees paid to insurance broker	BROKER BONUS
Insurance broker organization code?	3
Insurance broker name	NIELSEN INSURANCE COMPANY

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

000010103279

Policy instance

Insurance contract or identification number	000010103279
Number of Individuals Covered	121
Insurance policy start date	2011-07-01
Insurance policy end date	2012-06-30
Total amount of commissions paid to insurance broker	USD $897
Total amount of fees paid to insurance company	USD $235
Life Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Other welfare benefits provided	AD&D, LIFE
Welfare Benefit Premiums Paid to Carrier	USD $12,355
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $897
Amount paid for insurance broker fees	235
Additional information about fees paid to insurance broker	BROKER BONUS
Insurance broker organization code?	3
Insurance broker name	NIELSEN INSURANCE GROUP

ANTHEM BLUE CROSS AND BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 71835 )

Policy contract number

21721

Policy instance

Insurance contract or identification number	21721
Number of Individuals Covered	118
Insurance policy start date	2011-07-01
Insurance policy end date	2012-06-30
Total amount of commissions paid to insurance broker	USD $39,847
Health Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $1,285,281
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $39,847
Insurance broker organization code?	3
Insurance broker name	NIELSEN INSURANCE GROUP

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

000010103279

Policy instance

Insurance contract or identification number	000010103279
Number of Individuals Covered	112
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $879
Total amount of fees paid to insurance company	USD $235
Life Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Other welfare benefits provided	AD&D
Welfare Benefit Premiums Paid to Carrier	USD $11,284
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

ANTHEM BLUE CROSS AND BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 71835 )

Policy contract number

21721

Policy instance

Insurance contract or identification number	21721
Number of Individuals Covered	109
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $37,610
Health Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $1,177,223
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

000010104302

Policy instance

Insurance contract or identification number	000010104302
Number of Individuals Covered	112
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $3,602
Total amount of fees paid to insurance company	USD $553
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $28,559
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

000010104302

Policy instance

Insurance contract or identification number	000010104302
Number of Individuals Covered	92
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $3,137
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $27,668
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $3,137
Insurance broker name	NIELSEN INSURANCE COMPANY

ANTHEM BLUE CROSS AND BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 71835 )

Policy contract number

21721

Policy instance

Insurance contract or identification number	21721
Number of Individuals Covered	93
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $29,221
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $965,315
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $29,221
Insurance broker name	NIELSEN INSURANCE GROUP

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

000010103279

Policy instance

Insurance contract or identification number	000010103279
Number of Individuals Covered	92
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $814
Life Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Other welfare benefits provided	AD&D
Welfare Benefit Premiums Paid to Carrier	USD $11,732
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $814
Insurance broker organization code?	3
Insurance broker name	NIELSEN INSURANCE GROUP

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Company Name:	APPLIED ENGINEERING MANAGEMENT CORPORATION
Employer identification number (EIN):	770113181
NAIC Classification:	541511
NAIC Description:	Custom Computer Programming Services

Jurisdiction of Incorporation:	Texas Secretary of State
Incorporation Date:	1996-03-03
Company Identification Number:	0011094006
Legal Registered Office Address:	PO BOX 1263 CAMARILLO United States of America (USA) 93011

Plan id#	Filing Submission Date	Name of Administrator
502	2017-01-01	SHARON DEMONSABERT
502	2017-01-01
502	2016-01-01	SHARON DEMONSABERT
502	2015-01-01	SHARON DEMONSABERT
502	2014-01-01	SHARON DEMONSABERT
502	2013-01-01	SHARON DEMONSABERT
502	2012-01-01	SHARON DEMONSABERT
502	2011-01-01	SHARON DEMONSABERT
502	2010-01-01	SHARON DEMONSABERT
502	2009-01-01	SHARON DEMONSABERT